Do You and Your Doctor See Eye-to-Eye on Migraine?

Good communication is the foundation of every relationship. That includes the one you have with your doctor.

If you have migraine, it's so important that the two of you develop a great relationship. You need to be comfortable talking about your condition and your treatment.

Sometimes you may not see eye-to-eye. That can be tough for you -- and your doctor. Still, you can make your next migraine appointment a master class in good communication.

Lost in Translation

Even in the best of relationships, what we mean to say sometimes gets buried in the shuffle of our busy lives. Unfortunately, that can be true in your connection with your doctor, too.

One study showed that communication between people with chronic migraines (15 or more days a month) and their doctors could fall short. The study said one way it can go off track is when doctors don't ask questions in a way that gives people an opening to talk about how migraines affect their lives. That can leave some feeling as if they didn't get individual attention.

Have you ever said something to a spouse or a friend like, “You look really good today,” and what they think is “What? Do I look lousy every other day?” Sometimes, miscommunication happens between folks and their doctors, too.

For example, your doctor may tell you that abnormal blood vessels in your brain may cause migraine. You may hear “abnormal” and think your vessels could burst. This could cause you to worry needlessly.

Some research shows that doctors and the folks they treat may not even understand what they want from each other.

Many people want a doctor who answers their questions and teaches them about treatment. Some doctors think most people want their expertise in headache treatment, mixed with a bit of compassion and understanding.

Jennifer Kriegler, MD, a neurologist with the Cleveland Clinic’s Center for Neurological Restoration, says that while everyone that goes to a doctor is unique, they all want the same thing: a better, pain-free life.

“So doctors need to find ways to achieve that goal and to make sure there aren’t any communication barriers, Kriegler says. “And we need some help [from you] to make sure we get there.”

Come Prepared -- and Speak Up

One way to help your doctor (and yourself) see eye-to-eye is to read up on migraines and be ready to talk about what you want from your treatment.

“We aren’t asking people to be migraine experts, but the more they know about their migraines, the better the conversation, and then we can get on the same page,” says Robert Kaniecki, MD, director of the Headache Center at the University of Pittsburgh Medical Center.

Getting on that page might be a little tricky. Research shows that many doctors can interrupt the folks who need treatment. You may have to be a little bit firm when it’s your turn to talk, just like you may be with your kids (or a friend or spouse), if your doctor interrupts you.

To make sure you're heard during your visit, track your migraines with a “headache diary.” It doesn’t have to be fancy, but make sure it has:

The date of your migraine(s)

The time of day they began

How long they lasted

How you treated them

If what you did worked

If your migraine keeps you from commitments

“I’m a huge fan of the headache diary, because we have something very concrete to talk about,” says Aamir Hussain, MD, of University Hospitals Cleveland Medical Center.

Don’t be afraid to go all in and explain how your migraine affects your life.

“If someone comes into the office and says, 'I have migraines and I get these headaches at work,' that gives us a place to start an important conversation," says Michael Hanak, MD, assistant professor of family medicine at Rush Medical College in Chicago.

That discussion can include:

Potential treatments

Stress management

Identification of triggers

Be clear and concise. If your doctor starts using terms you don’t understand, let him know. Hanak suggests you ask the doctor if you can repeat back to him what he said to make sure you didn't miss anything.

“You owe it to yourself to make sure you understand what your doctor is saying all the time, not some of the time,” he adds.

Be Realistic

One of the most difficult truths about migraine is that there's no cure.

"We may not do a great job in explaining that,” Kaniecki says.

The goal of migraine treatment is twofold:

To make your pain come less often

To stop a migraine when it comes

Sometimes, a treatment may work better than at other times.

“Migraine is a very smart disease, and it can be frustrating ... since no treatment is 100% effective all of the time,” he says.

Unfortunately, some folks may be afraid to speak up because they think they failed. Or they think they just have to live with the pain.

“Migraines aren’t someone’s fault, and we want the best treatment plans," Hussain says. "So make sure you are firm, and tell us what is working and what isn’t working.”

If you do that, your doctor may be able to tweak a regimen or explore options like meditation that may help, he says.

That means avoiding your triggers and taking your medicine as prescribed all of the time, not just some of the time.

“Good medicine is a real partnership between [people] and their doctors, and great partnerships mean people should be able to communicate openly and honestly,” Kriegler says. “Migraine can be managed, so let’s find a way to work together.”